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Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291.

Background: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the airways associated with airway narrowing with airflow obstruction leading to difficulty in breathing impair daily activity and cause poor quality of life. Patients and methods: Fifty patients whom diagnosed with COPD are divided into two groups, 1st control group includes 25 patients assigned to receive conventional therapy of Formoterol fumarate 12 microgram inhaler twice daily, and 2nd interventional group also includes 25 patients assigned to receive conventional therapy with (300 mg/ 2 times daily) sublingual glutathione for two months. Saint George respiratory questionnaire (SGRQ) were measured before and after first and second months after treatment in both study groups. Aim of the study: This study was object to assess the changes in quality of life by using SGRQ following sublingual glutathione supplements therapy in COPD patients. Results and conclusion: After two months treatment , the mean values of SGRQ showed a significant increase compared to pre-treatment levels in both groups (P

Objective: Early adversity, such as adverse childhood experiences (ACEs), is a risk factor for the development of substance use disorder (SUD). ACEs are associated with earlier initiation of substance use. This study examined the relationship between ACEs and age of initiation of substance use using survival analysis. It is hypothesized that individuals with higher ACEs will have an earlier age of initiation. Method: Participants were recruited from the University of Kentucky's Laboratory for Human Behavioral Pharmacology. Participants were 18 years or older, English speaking, and actively engaged in substance use. Participants were not in substance abuse treatment nor were they seeking treatment. ACE scores were calculated, and age of substance use initiation was recorded. A Cox proportional hazard model was used to examine the effect of ACE score on age of substance use initiation. Results: A total of 107 participants completed the study. An average number of 2.3 ACEs (SD = 2.2) were endorsed with 24% of participants reporting 4 or more ACEs. Higher ACE scores were associated with cigarette smoking and non-medical prescription opioid use onset (hazard ratio (HR) = 1.14, 95% CI=1.02–1.28, p = 0.02, and HR=1.19, 95% CI = 1.04–1.37, p = 0.01, respectively. Conclusions: A significant association was found between higher ACE scores and earlier initiation of cigarette and non-medical prescription opioid use, consistent with prior research. Primary prevention of ACEs, screening for ACEs during childhood, and interventions for ACEs if detected, may help to reduce the risk of substance use/SUD in adulthood. [ABSTRACT FROM AUTHOR]

Cotton is a major oil and fiber crop in many countries around the globe. The primary constraint in cotton cultivation is water scarcity. Thus, the adoption of economical and best management practices (BMP) are needed to improve productivity on a sustainable irrigation basis. We investigated the economic and agronomic benefits of sustainable irrigation [(control and partial rhizosphere drying (PRD)] and BMP (no-mulched, black plastic, wheat straw, and cotton stick) treatments, to find a combination of strategies towards a higher yield and economic return. Our findings revealed that PRD irrigation significantly increased cotton yield by 35%, improved water use efficiency (WUE) by 21%, and enhanced the economic returns of cotton production. Maximum expenditure was found in control irrigation treatment with wheat straw mulch. The control treatment, which involved full irrigation with cotton and wheat straw mulch, exhibited the highest recorded benefit-cost ratio (BCR) of 2.09:1. Conversely, the treatment that utilized PRD without the application of mulch material demonstrated the lowest BCR of 1.05:1. Maximum net field benefit (174514 Rs/ha) was recorded in a combination of control irrigation with wheat straw mulch. Among the PRD treatments, the maximum net field benefit was recorded in PRD with wheat straw mulch (89179 Rs/ha) followed by PRD with black plastic mulch (72236 Rs/ha), and minimum (84085 Rs/ha) net field benefit was recorded in PRD with cotton sticks mulch. The results showed that the combination of sustainable irrigation with BMP is a reliable strategy to increase WUE and economic gains to meet sustainable development goals in the era of global warming, climate change, and water crisis. [ABSTRACT FROM AUTHOR]

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